The relationship between internal and external factors about the outpatients' choice of hospital: A cross-sectional study from Jiaxing City, China.

Background And Aims: Exploring the mechanism influencing the choice of hospital among patients is important to render better care to them. The main purpose of this study is to evaluate the relationship between outpatients' different internal factors (sociodemographic and psychological characteristics) and different external factors (provider characteristics) regarding their choice of hospital.

Methods: The data obtained via questionnaire was analyzed with a linear regression model to verify the relationship between outpatients' internal and external factors. In addition, for external factors, we built a score reflecting a comprehensive hospital's "hard power" (diagnosis and treatment technology and expertise, i.e., to say, the curative capability) and "soft power" (whether the environment for seeing a doctor is convenient and cheap, etc.) factors which influence the choice of outpatients, and the factors were given different points and weighted according to the option's order of the questionnaire.

Results: We did not see evidence that internal factors such as gender, age, birthplace, and having or not having medical insurance had an effect on the comprehensive external factors of the hospital's choice ( > 0.05). However, statistically significant differences were found ( < 0.001) that outpatients who usually resided near Jiaxing valued hospitals' "hard power" to a greater extent than did outpatients who lived in Jiaxing city, otherwise, "soft power" was prioritized. Similarly, outpatients who recognized themselves as having serious diseases valued hospitals' "hard power" to a greater extent than those with moderate or minor diseases, otherwise, "soft power" was prioritized ( = 0.03).

Conclusion: By enhancing the hospital's "soft power," the managers of small hospitals could attract different outpatients from large hospitals, such as outpatients with minor or moderate diseases. Moreover, the regional health service organizations should promote the building of first- and second-level hospitals near cities to retain more outpatients and to achieve outpatients' diversion from large tertiary hospitals.